Management of redislocated Colles' fractures

Area of Science:

• Orthopedics
• Traumatology
• Radiology

Background:

• Colles' fractures are common wrist fractures, and redisplacement after initial reduction can occur.
• Accurate reduction of Colles' fractures is often correlated with favorable functional and cosmetic outcomes.
• Clinical decisions regarding re-reduction for redisplaced Colles' fractures require careful consideration of potential benefits.

Purpose of the Study:

• To evaluate the effectiveness of renewed reduction for redislocated Colles' fractures.
• To determine the optimal timing for performing re-reduction procedures.
• To assess the likelihood of achieving lasting improvement after re-reduction.

Main Methods:

• Review of roentgenograms from 40 patients with rereduced Colles' fractures.
• Categorization of fractures into early (1-6 days) and late (7-15 days) re-reduction groups.
• Analysis of functional and cosmetic outcomes based on radiographic evidence.

Main Results:

• Approximately one-third of all cases showed permanent improvement following renewed reduction.
• Early re-reduction (1-6 days) resulted in lasting improvement in only 2 out of 15 cases.
• Late re-reduction (7-15 days) led to permanent improvement in 15 out of 30 cases, specifically regarding dorsal angulation and radial compression.

Conclusions:

• Renewed reduction can lead to lasting improvement in approximately one-third of redislocated Colles' fractures.
• Late re-reduction, specifically during the second week after the primary reduction, appears more effective than early re-reduction.
• The findings suggest that timing is a critical factor in achieving successful outcomes for redislocated Colles' fractures.